Examinando por Autor "Urina-Triana, Miguel"
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Ítem Clinical, microbiological, and imaging characteristics of infective endocarditis in Latin America: a systematic review(Elsevier -- International Society for Infectious Diseases, 2022) Urina-Jassir, Manuel; Jaimes-Reyes, María Alejandra; Martinez-Vernaza, Samuel; Quiroga-Vergara, Camilo; Urina-Triana, MiguelObjectives: We aimed to describe the clinical, microbiological, and imaging characteristics of patients with infective endocarditis (IE) in studies from Latin America (LATAM). Methods: A systematic search through PubMed, EMBASE, LILACS, and SciELO from inception until Febru ary 2021 was conducted. We included observational studies that assessed adults with IE from LATAM and reported data on clinical, microbiological, or imaging characteristics. Data were independently extracted by 2 authors and the risk of bias was evaluated by study design with its respective tool. Findings were summarized using descriptive statistics. Results: Forty-four studies were included. Most cases were male (68.5%), had a predisposing condition including valve disease (24.3%), or had a prosthetic valve (23.4%). Clinical manifestations included fever (83.9%), malaise (63.2%), or heart murmur (57.7%). A total of 36.4% and 27.1% developed heart failure or embolism, respectively. Blood cultures were negative in 23.9% and S. aureus (18.6%) and the viridans group streptococci (17.8%) were the most common isolates. Most cases were native valve IE (67.3%) affecting mainly left-sided valves. Echocardiographic findings included vegetations (84.3%) and regurgitation (75.9%). In-hospital mortality was 25.1%. Conclusions: This is the first systematic review that evaluated the characteristics of IE in LATAM patients. A lack of multicenter studies reflects the need for these studies in LATAM.Ítem Consideraciones especiales de la hipertensión arterial sistémica en afrodescendientes de América latina(Cooperativa servicios y suministros 212518 RS, 2017) Urina-Triana, Miguel; Urina-Jassir, Daniela; Urina-Jassir, Manuel; Urina-Triana, ManuelEn América Latina hacer un análisis del impacto en la prevalencia de hipertensión arterial producto de la participación de la raza negra en su origen es complejo ya que no hay muchos estudios que analicen esta problemática y en particular porque el comportamiento migratorio que originó la presencia de la raza negra en nuestro continente no tuvo el mismo comportamiento en todos los países. Se requiere que se aumenten las estrategias para lograr la detección, aumentar la cobertura y optimizar el tratamiento en los individuos afrodescendientes en Latinoamérica. Se necesitan estudios con suficiente tamaño de muestra para ver las diferencias según género, pureza de la raza, mestizaje, influjo social, migraciones, industrialización y severidad de la hipertensión arterial.Ítem Las dislipidemias y su tratamiento en centros de altacomplejidad en Colombia(Sociedad Espanola de Arteriosclerosis, 2020) Ruiz, Álvaro J.; Vargas-Uricoechea, Hernando; Urina-Triana, Miguel; Román-González, Alejandro; Isazae, Daniel; Etayof, Edwin; Quintero, Adalberto; Molina, Dora Inés; Toro, Juan Manuel; Parra, Gustavo; Merchán, Alonso; Cadena, Alberto; Yupanqui Lozano, Hernán; Cárdenas, Juan Mauricio; Quintero, Álvaro Mauricio; Botero, Rodrigo; Jaramillo, Mónica; Arteaga, Juan Manuel; Vesga-Angaritar, Boris; Valenzuela-Plata, Etna; Betancur-Valencia, MónicaAntecedentes y objetivo: Los datos sobre la distribución de las dislipidemias en Colombia sonlimitados. El objetivo primario de este estudio fue describir la frecuencia de las dislipidemias; los objetivos secundarios fueron: la frecuencia de comorbilidades cardiovasculares, el uso de estatinas y otros hipolipemiantes, la frecuencia de intolerancia a estatinas, el porcentaje de pacientes en metas de c-LDL, y estimar la distribución del riesgo cardiovascular (RCV).Materiales y métodos: Estudio transversal con recolección de datos retrospectiva que incluyóa 461 pacientes con diagnóstico de dislipidemia tratados en 17 centros cardiovasculares de altacomplejidad en las 6 principales áreas geográficas y económicas de Colombia.Resultados: La media (DE) de edad de los pacientes incluidos fue de 66,4 (±12,3) a˜nos. El 53,4%(246) eran mujeres. Las dislipidemias se distribuyeron así: dislipidemia mixta (51,4%), hiperco-lesterolemia (41,0%), hipertrigliceridemia (5,4%), hipercolesterolemia familiar (3,3%) y c-HDLbajo (0,7%). El medicamento más prescrito fue atorvastatina (75,7%), seguido de rosuvastatina(24,9%). El 55% del total de pacientes y el 28,6% de aquellos con enfermedad coronaria noestaban en metas de c-LDL a pesar del tratamiento. La frecuencia de intolerancia a estatinas fue del 2,6%.Conclusiones: La dislipidemia mixta y la hipercolesterolemia son las dislipidemias más frecuentes. Un porcentaje considerable de pacientes en tratamiento, incluidos aquellos con enfermedad coronaria, no lograron sus objetivos de c-LDL. Este inadecuado control lipídicoinfluye en el RCV y requiere un cambio en las estrategias terapéuticas, intensificando el trata-miento con estatinas o adicionando nuevos fármacos en los pacientes con mayor RCV.© 2020 Sociedad Española de Arteriosclerosis. Publicado por Elsevier España, S.L.U. Todos los derechos reservados.Ítem Efectos de un programa de ejercicio físico de 12 semanas en sujetos con revascularización coronaria o postangioplastia transluminal percutánea(Sociedad Colombiana de Cardiología y Cirugía Cardiovascular, 2017) Mantilla-Morrón, Mirary; Urina-Triana, Miguel; Herazo-Beltrán, Yaneth; Urina-Jassir, DanielaObjetivo: Determinar los efectos de un programa de ejercicio físico sobre las características antropométricas y la capacidad funcional postcirugía de revascularización coronaria o postangioplastia coronaria transluminal percutánea. Métodos: Estudio clínico no controlado, de antes y después, en 49 pacientes postcirugía de revascularización coronaria o angioplastia coronaria percutánea. El índice de masa corporal, perímetro abdominal, índice de cintura cadera, perímetro de la cadera y la capacidad cardiorrespiratoria a través de la caminata de los seis minutos fueron evaluados antes y al finalizar el programa de ejercicio físico. Este estuvo conformado por ejercicios aeróbicos continuos, de resistencia muscular, equilibrio y coordinación, durante 3 días a la semana, durante 12 semanas. Resultados: Con relación al perímetro abdominal en las mujeres cambió de 91,4 cm a 88,4 cm (p = 0,003) y en los hombres de 93,6 cm a 89,8 (p = 0,000). Se logró un incremento significativo de la distancia caminada de 330 a 436 metros (p = 0,000); del consumo energético de 3,4 a 4,1 MET (p = 0,000); y la máxima capacidad de absorber, transportar y consumir el oxígeno, de 12 a 14 ml/Kg/min. Conclusiones: El programa de ejercicio físico que fue utilizado en este estudio, pudo en todos los sujetos incrementar la capacidad cardiorrespiratoria y la tolerancia al ejercicio, y disminuir el perímetro abdominal. Los efectos benéficos obtenidos cambian el pronóstico de la enfermedad coronaria y disminuyen los factores de riesgo metabólicos.Ítem The effect of comorbidities on glycemic control among Colombian adults with diabetes mellitus: a longitudinal approach with real-world data(BMC, 2021) Urina-Jassir, Manuel; Herrera-Parra, Lina Johana; Hernández Vargas, Juliana Alexandra; Valbuena-García, Ana María; Acuña-Merchán, Lizbeth; Urina-Triana, MiguelBackground: Achieving an optimal glycemic control has been described to reduce the incidence of diabetes mellitus (DM) related complications. The association between comorbidities and glycemic control remains unclear. Our aim is to evaluate the effect of comorbidities on glycemic control in people living with DM. Methods: A retrospective longitudinal study on data from the National Registry of Chronic Kidney Disease from 2014 to 2019 in Colombia. The outcome was poor glycemic control (PGC = HbA1c ≥7.0%). The association between each comorbidity (hypertension (HTN), chronic kidney disease (CKD) or obesity) and PGC was evaluated through multivariate mixed effects logistic regression models. The measures of effect were odds ratios (OR) and their 95% confidence intervals (CI). We also evaluated the main associations stratified by gender, insurance, and early onset diabetes as well as statistical interaction between each comorbidity and ethnicity. Results: From 969,531 people at baseline, 85% had at least one comorbidity; they were older and mostly female. In people living with DM and CKD, the odds of having a PGC were 78% (OR: 1.78, CI 95%: 1.55-2.05) higher than those without CKD. Same pattern was observed in obese for whom the odds were 52% (OR: 1.52, CI 95%: 1.31-1.75) higher than in non-obese. Non-significant association was found between HTN and PGC. We found statistical interaction between comorbidities and ethnicity (afro descendant) as well as effect modification by health insurance and early onset DM. Conclusions: Prevalence of comorbidities was high in adults living with DM. Patients with concomitant CKD or obesity had significantly higher odds of having a PGC.Ítem Effects of a 12-week exercise-based program on the quality of life among myocardial revascularization subjects with normal and reduced left ventricular ejection fraction(Sociedad Latinoamericana de Hipertensión, 2019) Mantilla-Morrón, Mirary; Urina-Triana, Miguel; Herazo-Beltrán, Yaneth; Urina-Jassir, Daniela; Castro-Mier, Kevin Eduardo; Rodríguez-Pérez, LilianaBackground/Aims/: Exercise-based cardiac rehabilitation is an effective and safe therapy to be used in the management of clinically stable patients following percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG). Objectives: To determine if a 12-week physical exercise program (12-WPEP), after PCI or CABG with different left ventricular ejection fraction (LVEF) might improve the health-related quality of life (HRQOL). Methods: A prospective, controlled before-after study was conducted in a cardiac rehabilitation service with a 12-WPEP. Each session had a duration between 40 to 60 minutes, three times per week. Before and after a 12-WPEP was evaluated HRQOL using the SF-36 questionnaire. Results: The 12-WPEP improve the HRQOL but did not show differences among PCI (31 subjects) compared to CABG (18 subjects), regardless of whether the LVEF was normal or reduced (p<0.005). Conclusion: 12-WPEP improved HRQOL in both PCI and CABG subjects regardless of LVEF.Ítem Estimation of PQ distance dispersion for atrial fibrillation detection(Elsevier, 2021) Giraldo-Guzmán, Jader; Kotas, Marian; Castells, Francisco; Contreras-Ortiz, Sonia H.; Urina-Triana, MiguelBackground and objective: Atrial fibrillation (AF) is the most common cardiac arrhythmia in the world. It is associated with significantly increased morbidity and mortality. Diagnosis of the disease can be based on the analysis of the electrical atrial activity, on quantification of the heart rate irregularity or on a mixture of the both approaches. Since the amplitude of the atrial waves is small, their analysis can lead to false results. On the other hand, the heart rate based analysis usually leads to many unnecessary warnings. Therefore, our goal is to develop a new method for effective AF detection based on the analysis of the electrical atrial waves. Methods: The proposed method employs the fact that there is a lack of repeatable P waves preceding QRS complexes during AF. We apply the operation of spatio-temporal filtering (STF) to magnify and detect the prominent spatio-temporal patterns (STP) within the P waves in multi-channel ECG recordings. Later we measure their distances (PQ) to the succeeding QRS complexes, and we estimate dispersion of the ob- tained PQ series. For signals with normal sinus rhythm, this dispersion is usually very low, and contrary, for AF it is much raised. This allows for effective discrimination of this cardiologic disorder. Results: Tested on an ECG database consisting of AF cases, normal rhythm cases and cases with normal rhythm restored by the use of cardioversion, the method proposed allowed for AF detection with the accuracy of 98 . 75% on the basis of both 8–channel and 2–channel signals of 12 s length. When the signals length was decreased to 6 s, the accuracy varied in the range of 95% −97 . 5% depending on the number of channels and the dispersion measure applied. Conclusions: Our approach allows for high accuracy of atrial fibrillation detection using the analysis of electrical atrial activity. The method can be applied to an early detection of the desease and can advanta- geously be used to decrease the number of false warnings in systems based on the analysis of the heart rate.Ítem Evaluación de la eficacia del ejercicio físico sobre la capacidad funcional de sujetos con enfermedad cardiovascular(Sociedad Latinoamericana de Hipertensión, 2018) Mantilla-Morrón, Mirary; Tepox-Bruno, Rodrigo; Urina-Triana, Miguel; Urina-Jassir, Daniela; Rebolledo-Cobos, Roberto; Galeano-Muñoz, Luisa; Gómez, Luis SantiagoEl entrenamiento aeróbico interválico (EAI) y la danza, pueden ser unos métodos apropiados para optimizar la resistencia aeróbica, umbral anaeróbico, función endotelial y cardiaca. El objetivo de este estudio fue comparar el EAI de moderada intensidad con la terapia de baile grupal y con el entrenamiento aeróbico continuo (EAC) sobre los cambios del VO2 pico en sujetos en fase II de tratamiento de rehabilitación cardiaca. Material y Métodos: Ensayo clínico aleatorio en sujetos con diagnóstico de cardiopatía isquémica en programa de rehabilitación cardiaca fase II. Se evaluaron tres programas de ejercicio físico: EAI, EAC y baile grupal, la capacidad funcional se evaluó mediante la prueba de caminata de seis minutos, antes y después de 12 sesiones de ejercicio. El VO2 pico se calculó con la fórmula modificada propuesta por el Colegio Americano de Medicina del Deporte. Resultados: Se incluyeron 30 sujetos (10 en cada grupo). El VO2 pico aumentó significativamente en todos los grupos después de 4 semanas, sin embargo, el grupo de entrenamiento aeróbico interválico (EAI) tuvo el mejor resultado y mejor capacidad funcional (MET). Conclusión: El EAI produjo mejor efecto en la capacidad funcional que los otros dos programas. Es necesario contar con más estudios para realizar una mejor evaluación a largo plazo de estos programas.Ítem Evaluación de la percepción en el uso de betabloqueadores para el tratamiento de la hipertensión arterial antes y después de una intervención educativa: resultados de una encuesta nacional(Cooperativa servicios y suministros 212518 RS, 2017) Urina-Jassir, Daniela; Urina-Triana, Miguel; Urina-Jassir, Manuel; Balaguera-Mendoza, José; Montenegro- Rolong, Luis; Urina-Triana, ManuelIntroducción: Los betabloqueadores (BB) son utilizados como tratamiento de la hipertensión arterial. Objetivo: Evaluar la percepción del médico general sobre la prescripción de BB en hipertensión arterial, así como el efecto de una intervención educativa sobre dicha percepción. Métodos: En médicos generales que dentro de su actividad atendieran a sujetos con hipertensión arterial, se evaluó la percepción del uso de BB mediante cuestionario que revisó los siguientes aspectos: 1) uso de los BB como fármacos de primera línea, 2) utilización en hipertensos con Diabetes Mellitus Tipo 2, 3) producción de disfunción eréctil, 4) combinación con otros antihipertensivos y 5) control adecuado de la tensión arterial en corto tiempo. Seguidamente se hizo intervención educativa tipo conferencia sobre “Controversias del uso de BB en hipertensión arterial”. Posterior a ella se volvió a aplicar el mismo cuestionario utilizado antes de la misma. Resultados: La encuesta se llevó a cabo en 615 médicos generales en 18 ciudades de Colombia, el promedio de edad de los participantes fue de 38,5 ±7,5, años, con una distribucion por genero de 50,24% hombres y de 49,76% mujeres, el promedio de años de práctica fue de 13,5 ± 9,5 . La percepción a la primera pregunta cambió de 51.27% (Sí) a 88. 4% (Sí) (p = 0.001) y de 48.16% (No) a 10.85% (p = 000001). La segunda de 74,5% (Sí) a 95% (Sí) (p = 0,11) y de 24,84% (No) a 4,42% (No) (p = 0,001). La tercera de 43.05% (Sí) a 19.2% (Sí) (p = 0.002) y de 55.22% (no) a 78.71 (0.042). El cuarto y quinto aspecto evaluados no tuvieron modificaciones. Conclusión: La intervención educativa modificó los tres primeros aspectos evaluados, pero, en los dos últimos, no hubo cambios ya que, desde el principio, los encuestados tenían una percepción de uso elevada.Ítem La importancia de la evaluación de la fragilidad en el adulto mayor con enfermedad cardiovascular(Cooperativa servicios y suministros 212518 RS, 2018) Quintero-Cruz, María Victoria; Mantilla-Morrón, Mirary; Urina-Triana, MiguelLa fragilidad se considera como un síndrome biológico que afecta a múltiples sistemas y órganos que conduce a la dependencia e incluso la muerte; de allí la importancia de su medición en el adulto mayor, particularmente en el sujeto con enfermedad cardiovascular. Este estudio se realizó con el objeto de determinar la prevalencia de la fragilidad y pre- fragilidad del adulto mayor que acude a un programa de rehabilitación cardiaca. Materiales y Métodos: Estudio observacional descriptivo transversal realizado en adultos mayores con enfermedad cardiovascular que asistían al programa de rehabilitación cardiovascular. La evaluación de la fragilidad se hizo mediante los cinco criterios propuestos por Fried: pérdida involuntaria de peso, baja energía o agotamiento, debilidad muscular, lentitud de la marcha y baja actividad física. Los datos se estudiaron mediante el análisis de varianza de una y dos vías y se consideró significativo estadísticamente una p<0,05. Resultados: Se incluyeron 35 adultos mayores de 60 años. Se encontró una prevalencia de fragilidad de 23% y pre-fragilidad de 54% con mayor frecuencia en mujeres, las personas frágiles y pre-frágiles se encuentran entre 60 y 75 años, las mayores de 76 años son frágiles. La mayoría de los sujetos presentan entre 1 y 2 criterios siendo los de mayor prevalencia la lentitud para la marcha y la baja fuerza muscular (51,4%). Conclusión: Evaluar la fragilidad es importante en todo paciente con enfermedad cardiovascular (ECV) para detectarla y evitar dependencia. Es necesario mayor número de estudios sobre el tema con el fin de conocer la situación de estos pacientes en Barranquilla.Ítem Latin American Consensus on management of residual cardiometabolic risk. A consensus paper prepared by the Latin American Academy for the Study of Lipids and Cardiometabolic Risk (ALALIP) endorsed by the Inter-American Society of Cardiology (IASC), the International Atherosclerosis Society (IAS), and the Pan-American College of Endothelium (PACE)(Permanyer, 2021) Ponte-Negretti, Carlos I.; S. Wyss, Fernando; Piskorz, Daniel; D Santos, Raul; Villar, Raul; Lorenzatti, Alberto; López-Jaramillo, Patricio; Toth, Peter; J. Amaro, A. Juan; Rodrigo, Alfonso K.; Lanas, Fernando; Urina-Triana, Miguel; Lara, Jofre; Valdés, T. Osiris; Gomez-Mancebo, José R.; Bryce, Alfonso; Cobos S, Leonardo; Puente-Barragan, Adriana; Ullauri-Solórzano, Vladimir E.; Medina-Palomino, Felix A.; Lozada, Alfredo F.; Duran, Maritza; Berrospi, Percy; Miranda, David; Badimon, Juan J.; R. González, J. José; Libby, PeterHypertension, hyperglycemia, dyslipidemia, overweight, obesity, and tobacco (smoking, chewing, and vaping), together with a pro-inflammatory and procoagulant state, are the main risk factors related to atherosclerotic cardiovascular disease. Objective and methods: A group of experts from the Americas, based on their clinical expertise in cardiology, cardiovascular prevention, and cardiometabolic (CM) diseases, joined together to develop these practical recommendations for the optimal evaluation and treatment of residual CM risk factors in Latin America, using a modified Delphi methodology (details in electronic TSI) to generate a comprehensive CM risk reduction guideline, and through personalized medicine and patient-centered decision, considering the cost-benefit ratio The process was well defined to avoid conflicts of interest that could bias the discussion and recommendations. Results: Residual risk reduction should consider therapeutic options adapt- ed to specific patient needs, based on five treatment objectives: triglyceride-rich lipoproteins, inflammation, impaired glucose metabolism, high blood pressure, and prothrombotic status. Comprehensive control of all CM risk factors should be a priority to deal with this important public health problem and prevent premature deaths. The recommendations in this paper address the evidence-based treatment of CM risk and are intended for clinical application in Latin American countries.Ítem May measurement month 2018: an analysis of blood pressure screening results from Colombia(European Society of Cardiology, 2020) Lopez-Jaramillo, Patricio; Otero, Johanna; Alvernia, Juliana; Ney-Salazar, Daniela; Lopez-Lopez, Jose; Accini, Jose L.; Aroca, Gustavo; Urina-Triana, Miguel; Sánchez-Vallejo, Gregorio; Arcos, Edgar; Casanova, María E.; García, Henry; Beaney, Thomas; Chis Ster, Anca; Poulter, Neil R.High blood pressure (BP) is the leading global preventable cause of death and the most common risk factor for cardiovascular disease (CVD). However, due to its asymptomatic nature, the lack of awareness of this condition causes underdiagnosis and low rates of adherence to pharmacological treatment. Looking for practical approaches to increase awareness worldwide, the International Society of Hypertension (ISH) implemented the 2nd May Measurement Month campaign in 2018 (MMM18). In order to contribute to this initiative, Colombia participated as one of the 89 countries involved in this hypertension screening programme. Blood pressure was measured in subjects from 11 departments in Colombia. Under the leadership of the Fundacio´n Oftalmolo´gica de Santander (FOSCAL), 400 volunteers across the country collected the data following the MMM protocol. Measurements from 35 548 participants with a mean age of 41.9 years were obtained. In total, 9475 (26.7%) of the total population studied had hypertension. Of those with hypertension, 69.9% of these subjects were aware of their condition, 65.0% were on antihypertensive medication, and 43.1% had controlled BP. Of those on medication, 66.3% had controlled BP. Hypertension screening, awareness, treatment, and control should be a priority in public health objectives due to its elevated burden of disease and direct association with increased CVD. The MMM campaign provided a positive impact in the diagnosis of hypertension across Colombia. Although efforts are being made to expand treatment capability and adherence, still more are needed to insure a broader coverage of antihypertensive medication in Colombia.Ítem May Measurement Month 2022: results from the global blood pressure screening campaign(BMJ, 2024) Beaney, Thomas; Keziah Kerr, Gabriele; Kiru, Gaia ; McArdle, Harsha; Schlaich, Markus; Schutte, Aletta E.; Stergiou, George S.; Ji-guang, Wang; Marin, Marcos J.; Henandez-Hernandez, Rafael; F. Diaz, Alejandro Bimbo; Alcocer, Luis; Lopez-Jaramillo, Patricio; Poulter, Neil; Lopez-Lopez, José P.; Otero, Odont Johanna; Zulma, Urbina; Sanchez-Vallejo, Gregorio; Narváez, Claudia; Camacho, Paul A.; Urina-Triana, Miguel; Quintero, Adalberto; Aroca, Gustavo; Campos, Alfonso; Arcos, Edgar; Pérez-Mayorga, Maritza; Mosquera, Walter; García-Ortiz, Luis H.Introduction Elevated blood pressure (BP) is the major contributor to mortality and disease burden worldwide. May Measurement Month (MMM) is a global BP screening campaign, which aims to raise awareness of BP measurement and provide evidence to inform and influence related health policy. Methods This cross-sectional survey included individuals aged≥18 years recruited through opportunistic sampling at sites in 60 countries during MMM 2022. Each participant had three sitting BP measurements and a questionnaire was completed including demographics, comorbidities and lifestyle factors. Hypertension was defined as a systolic BP≥140 mm Hg and/or a diastolic BP≥90 mm Hg (average of the second and third readings) or taking antihypertensive medication. Multiple imputation was used to estimate BP readings where any participant’s BP readings were missing. Linear mixed effects models were used to identify associations between participant characteristics and systolic or diastolic BP. Results Of the 715 518 participants surveyed (excluding 50 200 self-measured home BP screenees recruited via the ZOE Health Study app), 257 421 (36.0%) were identified as hypertensive, of whom 57.6% were aware and 49.3% were on antihypertensive medication. Of all participants with hypertension, 26.1% were controlled to <140/90 mm Hg and 12.0% to <130/80 mm Hg. Of those taking antihypertensive medication, 52.7% were taking only one drug class, 52.9% were controlled to <140/90 mm Hg and 24.4% to 130/80 mm Hg. In total, 190 314 (26.6% of total surveyed, 73.9% of hypertensives) participants screened were found to have untreated or inadequately treated hypertension. Only 27.6% of treated hypertensive participants were taking a statin. Substantial coexistence of diabetes, overweight and hypertension was apparent among participants.Ítem A narrative review and expert panel recommendations on dyslipidaemia management after acute coronary syndrome in countries outside western Europe and North America(Springer, 2020-02-12) Reda, Ashraf; Almahmeed, Wael; Idit, Dobrecky-Mery; Po-Hsun, Huang; Juarez-Herrera, Ursulo; Ranjith, Naresh; Sayre, Tobias; Urina-Triana, MiguelPatients who have experienced an acute coronary syndrome (ACS) are at very high risk of recurrent atherosclerotic cardiovascular disease (CVD) events. Dyslipidaemia, a major risk factor for CVD, is poorly controlled post ACS in countries outside Western Europe and North America, despite the availability of effective lipid-modifying therapies (LMTs) and guidelines governing their use. Recent guideline updates recommend that low-density lipoprotein cholesterol (LDL-C), the primary target for dyslipidaemia therapy, be reduced by C 50% and to \1.4 mmol/L (55 mg/dL) in patients at very high risk of CVD, including those with ACS. The high prevalence of CVD risk factors in some regions outside Western Europe and North America confers a higher risk of CVD on patients in these countries. ACS onset is often earlier in these patients, and they may be more challenging to treat. Other barriers to effective dyslipidaemia control include low awareness of the value of intensive lipid lowering in patients with ACS, physician non-adherence to guideline recommendations, and lack of efficacy of currently used LMTs. Lack of appropriate pathways to guide follow-up of patients with ACS post discharge and poor access to intensive medications are important factors limiting dyslipidaemia therapy in many countries. Opportunities exist to improve attainment of LDL-C targets by the use of country-specific treatment algorithms to promote adherence to guideline recommendations, medical education and greater prioritisation by healthcare systems of dyslipidaemia management in very high risk patients.Ítem Predictive model for the identification of activities of daily living (ADL) in indoor environments using classification techniques based on Machine Learning(Elsevier, 2021) García-Restrepo, Johanna; Ariza-Colpas, Paola Patricia; Oñate-Bowen, Alvaro Agustín; Suarez-Brieva, Eydy del Carmen; Urina-Triana, Miguel; De-la-Hoz-Franco, Emiro; Díaz-Martínez, Jorge Luis; Butt, Shariq Aziz; Molina_Estren, DiegoAI-based techniques have included countless applications within the engineering field. These range from the automation of important procedures in Industry and companies, to the field of Process Control. Smart Home (SH) technology is designed to help house residents improve their daily activities and therefore enrich the quality of life while preserving their privacy. An SH system is usually equipped with a collection of software interrelated with hardware components to monitor the living space by capturing the behavior of the resident and their occupations. By doing so, the system can report risks, situations, and act on behalf of the resident to their satisfaction. This research article shows the experimentation carried out with the human activity recognition dataset, CASAS Kyoto, through preprocessing and cleaning processes of the data, showing the Vía Regression classifier as an excellent option to process this type of data with an accuracy 99.7% effectiveÍtem La prevalencia del síndrome metabólico en mujeres postmenopáusicas(Cooperativa servicios y suministros 212518 RS, 2018) Urina-Jassir, Daniela; Urina-Jassir, Manuel; Urina-Triana, Miguel; Mantilla-Morrón, Mirary; Urina-Triana, Manuel; Galeano-Muñoz, LuisaIntroducción y Objetivos: El desarrollo del aumento de la grasa central abdominal, de la alteración del perfil lipídico y de la resistencia a la insulina encontrado en el síndrome metabólico están mayormente presentes en la menopausia. Conocer la prevalencia del SM en mujeres postmenopáusicas en Barranquilla, permitirá desarrollar estrategias futuras para disminuir su presencia y la de las enfermedades cardiovasculares. Material y Métodos: Estudio transversal, realizado en Barranquilla, Colombia entre octubre a noviembre 2016, en mujeres con edad laboral. El diagnóstico del SM se hizo con al menos tres de los cinco criterios propuestos por el consenso de la Federación Internacional de Diabetes, del Instituto Nacional del Corazón, Pulmón y Sangre, de la Asociación Americana del Corazón, de la Federación Mundial del Corazón, de la Sociedad Internacional de Aterosclerosis y de la Asociación Internacional para el Estudio de la Obesidad. Resultados: Se incluyeron 773 mujeres, 78,65% premenopaúsicas (n=608) y 21,35% post- menopáusicas (n=165). El 27,8% (n=46) de mujeres post-menopáusicas tenían SM vs. 14,6% (n=89) de las pre-menopaúsicas, con una diferencia estadísticamente significativa de p<0,0001 (Chi-cuadrado 15.7845). Conclusiones: En las mujeres post-menopáusicas se manifestó una mayor incidencia de SM cuando se compara con las pre-menopaúsicas, por lo que se incrementa el riesgo cardiovascular. Se sugiere que deberían ser tratadas en forma temprana con el fin de reducir su mortalidad.Ítem Prospective evaluation of lipid management following acute coronary syndrome in non-Western countries(Wiley, 2021) Navar, Ann Marie; Matskeplishvili, Simon T.; Urina-Triana, Miguel; Arafah, Mohammed; Chen, Jaw-Wen; Sukonthasarn, Apichard; Corp dit Genti, Valérie; Daclin, Véronique; Peterson, Eric D.Background: Half the global burden of cardiovascular disease (CVD) is concentrated in the Asia-Pacific (APAC) region. Hypothesis: Suboptimal control of low-density lipoprotein cholesterol (LDL-C) may play a large role in the burden of CVD in APAC and non-Western countries. Methods: The Acute Coronary Syndrome Management (ACOSYM) registry is a multinational, multicenter, prospective observational registry designed to evaluate LDL-C control in patients within 6 months after hospitalization following an acute coronary syndrome (ACS) event across nine countries. Results: Overall, 1581 patients were enrolled, of whom 1567 patients met the eligibility criteria; 80.3% of the eligible patients were men, 46.1% had ST-elevation myocardial infarction, and 39.5% had non-ST-elevation myocardial infarction. Most (1245; 79.5%) patients were discharged on a high-intensity statin. During the followup, only 992 (63.3%) patients had at least one LDL-C measurement; of these, 52.9% had persistently elevated LDL-C (>70 mg/dl). The patients not discharged on a highdose statin were more likely (OR 3.2; 95% CI 2.1–4.8) to have an LDL-C above the 70 mg/dl LDL-C target compared with those who were discharged on a high-dose statin. Conclusion: Our real-world registry found that a third or more of post-ACS patients did not have a repeat LDL-C follow-up measurement. In those with an LDL-C followup measurement, more than half (52.9%) were not achieving a <70 mg/dl LDL-C goal, despite a greater uptake of high-intensity statin therapy than has been observed in recent evidence. This demonstrates the opportunity to improve post-ACS lipid management in global community practice.Ítem Software Applications to Health Sector: A Systematic Review of Literature(Medwell Journals (Scientific Research Publishing Company), 2018) Calabria- Sarmiento, Juan C.; Ariza-Colpas, Paola; Pineres-Melo, Marlon; Ayala-Mantilla, Cristian; Urina-Triana, Miguel; Morales-Ortega, Roberto; Peluffo-Martinez, Gabriel; Mendoza-Palechor, Fabio; Echeverri-Ocampo, IsabelTechnology has become a strategic ally for the automation and improvement of processes in the health sector. Many of the current developments have supported the automatic, efficient and efficient detection of different pathologies which results in quality of life and treatment of patients. This study proposes a systematic review of the literature which compiles different developments that have contributed to the solution of different problems in the sector and the advances that have contributed to the processes of continuous improvement of detection and treatment.Ítem Statin associated adverse reactions in Latin America: a scoping review(BMJ Publishing Group, 2021) Urina-Jassir, Manuel; Pacheco-Paez, Tatiana; Paez-Canro, Carol; Urina-Triana, MiguelObjectives We aim to describe the frequency and type of adverse drug reactions (ADRs) in patients on statins in published studies from Latin American (LATAM) countries. Design Scoping review. Methods A literature search was conducted in three databases (PubMed, EMBASE and LILACS) in addition to a manual search in relevant journals from LATAM universities or medical societies. A snowballing technique was used to identify further references. Randomised controlled trials (RCTs) and observational studies between 2000 and 2020 were included. Studies were considered eligible if they included adults on statin therapy from LATAM and reported data on ADRs. Data on ADRs were abstracted and presented by study design. Results Out of 8076 articles, a total of 20 studies were included (7 RCTs and 13 observational studies). We identified three head-to-head statin RCTs, two statinversus-policosanol RCTs and only two placebo-controlled trials. The statin-related ADRs frequency ranged from 0% to 35.1% in RCTs and 0% to 28.4% in observational studies. The most common ADRs were muscle-related events including myalgia and elevated creatine phosphokinase. Other reported ADRs were gastrointestinal symptoms, headache and altered fasting plasma glucose.Ítem El trabajo colaborativo entre ingenieros y personal de la salud para el desarrollo de proyectos en salud digital: una visión al futuro para lograr tener éxito(Sociedad Venezolana de Farmacología Clínica y Terapéutica, 2018) Echeverri-Ocampo, Isabel; Urina-Triana, Miguel; Patricia Ariza, Paola; Mantilla, MiraryLas tendencias en tecnologías de la información y la comunicación (TIC) han fomentado el trabajo en conjunto entre el personal de la salud y los ingenieros, con el fin de desarrollar dispositivos que permitan el intercambio de datos en un espacio que propicie la facilidad de interacción y obtención de la información del paciente. Sin embargo, no es un campo explícito en las investigaciones de tecnología de la información en salud. Actualmente se ha estado fortaleciendo este campo de medicina digital, pero todavía es un campo que requiere una buena estrategia de trabajo colaborativo para el diseño de plataformas móviles, nubes de información, plataformas web entre otras. Por lo cual este artículo está basado en la identificación de los atributos de un buen trabajo colaborativo. Para ello, se realizó una revisión sistemática de la literatura sobre el trabajo en equipo interdisciplinario entre investigadores, tales como ingenieros y personal de la salud para implementar un sistema digitalizado que permita prevenir, dar terapias y diagnosticar, usando las tecnologías mencionadas anteriormente. Esta revisión presenta una visión general del trabajo colaborativo respondiendo a tres preguntas generadas durante el estudio.